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Organization
RED LAKE COMPREHENSIVE HEALTH SERVICES
Active
Organization
RED LAKE COMPREHENSIVE HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ORAN D. BEAULIEU (TRIBAL HEALTH DIRECTOR)
(218) 679-3316
Entity
Organization
Contact information
Practice address
24760 HOSPITAL DRIVE, REDLAKE, MN 56671-0249
(218) 679-3316
(218) 679-3990
Mailing address
PO BOX 249, REDLAKE, MN 56671-0249
(218) 679-3316
(218) 679-3990
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
MN
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
124Q00000X
Dental Hygienist
—
NULL
124Q00000X
Dental Hygienist
—
—
146N00000X
Basic Emergency Medical Technician
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222710000
—
MN
Enumeration date
01/31/2007
Last updated
05/20/2008
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